i \ 6 Dr. Reeve's Account of Cretinism. 
unwholesome, without any good reason. At Bern, the water 
is extremely pure, yet, as Haller remarks, swellings of the 
throat are not uncommon in both sexes, although cretinism 
is rare. With regard to the alledged causes of goitre, the 
general opinion of its being endemial in mountainous coun- 
tries, is of no value, because the disease is rare in Scotland, 
and very common in the county of Norfolk. 
The causes of cretinism begin to operate upon the system 
soon after, perhaps even before birth ; the want of energy in 
the parent is communicated to the offspring ; the children 
become deformed and cachectic very early in life, the growth 
and developement of the body is impeded, the abdomen be- 
comes enlarged, and the glands swelled in various degrees ; 
and the powers of the mind remain dormant, or become 
entirely obliterated, partly from want of proper organiza- 
tion, and partly from the total neglect of every thing like 
education. 
It might be expected, that the dissection of cretins would 
throw some light upon the series of phenomena associated 
together in the origin and progress of this singular affection ; 
but the people are so superstitious, that it is very difficult to pro - 
cure bodies for anatomical examination. However, some dis- 
sections have been made, and the appearances in the cranium 
are very curious. From the description of a cretin's skull by 
Ackermann, it appears that the cavity for the reception of 
the pons varolii and medulla oblongata was completely obli- 
terated, and that in which the cerebellum is lodged so much 
diminished, that it scarcely exceeded one-third of its natural 
capacity. The return of the venous blood must have been con- 
siderably impeded by the mal-confirmation of the foramina. 
